Effect of wheelchair headrest use on pediatric head and neck injury risk outcomes during rear impact

Comparative risks or benefits to wheelchair-seated pediatric occupants in motor vehicles associated with wheelchair headrest use during rear impact were evaluated using pediatric head and neck injury outcome measures. A Hybrid III 6-year-old anthropomorphic test device (ATD), seated in identical WC19-compliant pediatric manual wheelchairs, was used to measure head and neck response during a 25 km/h (16 mph), 11g rear impact. ATD responses were evaluated across two test scenarios: three sled tests conducted without headrests, and three with slightly modified commercial headrests. Head and neck injury outcomes measures included: linear head acceleration, head injury criteria (HIC) values, neck injury criteria (Nij) values, and combined rotational head velocity and acceleration. Neck and head injury outcome measures improved by 34–70% in sled tests conducted with headrests compared to tests without headrests. Headrest use reduced Nij values and the likelihood of concussion from values above established injury thresholds to values below injury thresholds. Injury measure outcome reductions suggest lower head and neck injury risks for wheelchair-seated children using wheelchair-mounted headrests as compared to non-headrest users in rear impact. Use of relative comparisons across two test scenarios served to minimize effects of ATD biofidelity limitations.